Maneuverability of the Scope and Instruments within Three Different Single-Incision Laparoscopic Ports: An Experimental Pilot Study.

Single-port access systems (SPASs) are currently used in human and veterinary surgeries. However, they pose technical challenges, such as instrument crowding, intra- and extracorporeal instrument collision, and reduced maneuverability. Studies comparing the maneuverability of the scopes and instruments in different SPASs are lacking. This study aimed to compare the maneuverability of three different SPASs: the Covidien SILS-port, Storz Endocone, and glove port. A clear acrylic box with artificial skin placed at the bottom was used to mimic the abdominal wall and cavity. The three SPASs were placed from below, and a 10-mm endoscope and 5-mm instrument were introduced. A motion analysis system consisting of 18 cameras and motion analysis software were used to track the movement of the endoscope and instrument, to determine the volume of the cone-shaped, three-dimensional figures over which movement was possible, with higher values indicating greater maneuverability. The Mann-Whitney U test was used for the analysis. The maneuverability of the endoscope alone was significantly higher in the glove port system than in the other two SPASs. When inserting an additional instrument, the maneuverability significantly decreased in the SILS-port and Endocone, but not in the glove port. The highest maneuverability overall was found in the glove port.

Development of a clinical tool to aid endotracheal tube size selection in dogs.

OBJECTIVE: To identify phenotypic parameters correlating with the inner tracheal diameter (ITD) and endotracheal tube size (ETS) in adult dogs and to develop a chart for ETS estimation. METHODS: Five-hundred and forty-four adult dogs; 100 dogs were enrolled prospectively and 444 dogs retrospectively. Different phenotypic parameters, the ITD on latero-lateral radiography and ETS were prospectively measured in dogs that underwent general anaesthesia. The parameter correlated best with the ITD was used to develop a graphic chart for ETS estimation. The accuracy of this chart was then retrospectively tested. RESULTS: In prospective cohort, the correlation between body size and body mass and ITD (r=0.85 and r=0.84) was good, and the highest correlation observed between ETS and body mass (rs=0.92, P<0.001). In the retrospective assessment, the mean difference between the predicted and used ETS was 0.0 (sd±0.84) for mesocephalic/dolicocephalic (MDC) dogs, showing high accuracy, but for brachycephalic dogs, it was 1.3 (sd±0.98). CONCLUSION: A graphic chart for ETS selection in dogs, using body mass, was designed in this study and was demonstrated to be accurate for ETS prediction in MDC dogs but not in brachycephalic dogs.

Enteroplication in cats with intussusception: a retrospective study (2001-2016).

OBJECTIVES: The aim of this study was to report complications, as well as short- and long-term clinical outcomes of cats suffering from surgically reduced intussusception with and without enteroplication. METHODS: Medical records of cats presented at our institution with intussusception between 2001 and 2016 were reviewed. The following data were retrieved: signalment; history; physical examination; diagnostic imaging, surgical and histological findings; and outcomes. Animals were grouped as with or without enteroplication. Duration of surgery, survival, complication and recurrence rates, duration of hospitalisation, and short- and long-term outcomes were compared. RESULTS: Cats with intussusception presented with unspecific type and duration of clinical signs. Male or male castrated cats and Maine Coons were over-represented in both groups. Enteroplication was performed in 48% (10/21) of the cats. Cats in the enteroplication group were significantly younger than those in the non-enteroplication group ( P = 0.023). Duration of surgery, time of hospitalisation, complication rate and outcomes did not differ between the two groups. Two complications in the short term and one complication in the long term were possibly associated with enteroplication. A recurrence of intussusception was seen in 2/17 cats approximately 12 months after initial surgery, both previously treated with enteroplication. CONCLUSIONS AND RELEVANCE: Although the number of cases was limited, our results suggest that enteroplication should be cautiously performed in cats with intussusception as it may be associated with major complications in the short and long term, and its efficacy remains unclear. Based on this study, the need for enteroplication in cats following a correction of intussusception could be questioned.

Left lateral liver lobe torsion in a cat with moderate pectus excavatum.

A 6-year-old neutered female domestic shorthair cat weighing 3.1 kg was referred to the clinic owing to a 2 day history of anorexia. On physical examination, a pectus excavatum (PE) was apparent, and a cranial abdominal mass was palpated. Serum biochemical analysis showed severely elevated liver enzymes. On radiography, the PE was graded as moderate, and a 5 × 3 cm soft tissue density mass was detected in the cranial abdomen. Using duplex ultrasonography, the mass was identified as an enlarged liver lobe with vascular thrombosis. The diagnosis of liver lobe torsion (LLT) was confirmed surgically, and the affected left lateral lobe was resected. On follow-up, performed 1 and 6 months postoperatively, no further abnormalities were found on clinical examination or serum biochemical analysis. At follow-up examination, the PE did not appear to cause any additional clinical signs, indicating that treatment of moderate PE in older animals is not obligatory. This is the first reported case of LLT with concurrent PE, and the second feline case of LLT treated surgically. Animals with anatomical malformation of the diaphragm caused by PE may be at higher risk of developing LLT. Early diagnosis and surgical intervention of LLT can produce a good clinical outcome without further repercussions.

Nitrate supplementation enhances the contractile properties of human skeletal muscle.

PURPOSE: Dietary nitrate supplementation positively affects cardiovascular function at rest and energy metabolism during exercise in humans and has recently also been reported to markedly enhance the in vitro contractile properties of mouse fast-twitch muscle. The aim of this study was to investigate the effects of short-term nitrate supplementation on the in vivo contractile properties of the skeletal muscle and voluntary muscle function of humans. METHODS: In a double-blind, randomized, crossover design, 19 healthy untrained men (21 ± 3 yr) ingested a nitrate-rich concentrated beetroot juice (NIT; nitrate dosage, approximately 9.7 mmol·d) and a placebo (PLA) for seven consecutive days. After the last supplementation dose, force was recorded while participants completed a series of voluntary and involuntary (electrically evoked) unilateral isometric contractions of the knee extensors. RESULTS: NIT enhanced the peak force response to low-frequency electrical stimulation, as follows: maximal twitch (NIT, 149 ± 41 N, vs PLA, 138 ± 37 N; P = 0.008; effect size, r (ES) = 0.56) and submaximal 1- to 20-Hz contractions (5%-10%, ES = 0.53-0.63). Whereas explosive (rising phase) force production during the first 50 ms of evoked maximal twitch and octet contractions (eight electrical impulses at 300 Hz) was also 3%-15% greater after NIT compared with that after PLA (P = 0.023-0.048, ES = 0.52-0.59), explosive voluntary force remained similar (P = 0.510, ES = 0.16). Maximum voluntary force was also unchanged after NIT (P = 0.539, ES = 0.15). CONCLUSIONS: These results indicate that 7 d of dietary nitrate supplementation enhanced the in vivo contractile properties of the human skeletal muscle. Specifically, nitrate supplementation improved excitation-contraction coupling at low frequencies of stimulation and enhanced evoked explosive force production but did not affect maximum or explosive voluntary force production in untrained individuals.